Improvement in mental health literacy among general public

Abstract

MedWire News: Results from a systematic review and meta-analysis of published studies suggest that mental health literacy has improved significantly among the general public in recent decades, but attitudes toward people with mental illnesses have not.

The findings indicate that greater efforts are needed to combat the stigma associated with mental health disorders, say Georg Schomerus (University of Greifswald, Germany) and colleagues.

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Writing in Acta Psychiatrica Scandinavica, the researchers explain: "The last decades have witnessed tremendous advancements of our understanding of the biological correlates of mental disorders.

"Not only has the knowledge of researchers and mental health professionals expanded, but the public, too, has been increasingly exposed to information on symptoms, biochemical, and genetic etiological theories and to the basic argument that the mental illnesses are diseases no different from other diseases, amenable to effective medical treatment."

To investigate whether the general public has become more knowledgeable about mental health disorders, and whether this has influenced attitudes towards people with such conditions, the team searched the literature for relevant studies published before March 2011 that had a follow-up interval of at least 2 years.

In total, 33 reports on 16 studies from Europe, the USA, Australia, and New Zealand regarding time-trends in beliefs and attitudes about mental illness in nationally representative population samples, covering periods from 3 to 46 years, were included in the meta-analysis.

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The researchers found that, overall, there was a significant trend to greater mental health literacy among the general population in recent decades.

For example, among six studies that used case vignettes to elicit causal beliefs for depression and schizophrenia, covering the years 1990-2006, agreement with an "inherited/genetic" cause increased by 1.3% per year for schizophrenia and by 1.2% per year for depression. The estimated increase in an "inherited/genetic" cause over the entire period across all six studies was 20.8% for schizophrenia and 19.2% for depression.

There was also greater acceptance of professional help for mental health problems. For example, in four studies covering the period 1990-2006, which examined beliefs regarding help-seeking for schizophrenia and depression, agreement with the recommendation "to visit a psychiatrist" increased by 1.3% per year for depression and 0.9% per year for schizophrenia. Belief in the effectiveness of drug treatment for schizophrenia also increased by an estimated 27.2% over the entire period.

However, the researchers note that there was no significant improvement in attitudes to people with mental health disorders over time, with some studies reporting a worsening of attitudes, such as an increase in the perception of mentally ill people being violent or frightening, and a decrease in social acceptance of mentally ill individuals, particularly those with schizophrenia.

Schomerus and team conclude: "Our systematic review and meta-analysis revealed a consistent evolution of public attitudes across different countries.

Two distinct developments emerged: first, the public's literacy about mental disorders clearly has increased. Second, at the same time, attitudes towards persons with mental illness have not changed for the better, and have even deteriorated towards persons with schizophrenia."

They add: "Education about biological correlates of mental disorders is not sufficient to improve attitudes towards persons with mental illness. Effective anti-stigma programs need to embrace other strategies, centered for example on consumer contact."